Comparison of adductor canal block and IPACK block (interspace between the popliteal artery and the capsule of the posterior knee) with adductor canal block alone after total knee arthroplasty: a prospective control trial on pain and knee function in immediate postoperative period

Sankineani, Sukesh Rao; Reddy, A.R.; Eachempati, Krishna Kiran; Jangale, Ajit; Reddy, A V Gurava

doi:10.1007/s00590-018-2218-7

Cited by 129 publications

(145 citation statements)

References 19 publications

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“…Despite reporting the same results, differences have been noted in the study design, data collection periods and methodologies described. The findings from the institutional investigation show that the current article [1] accurately reports the study. Since the investigation, the article published in International Journal of Orthopaedics Sciences has been removed from the journal site; however, since this article is still accessible elsewhere, the Editor-in-Chief is publishing this Editor's Note to alert the readership and provide clarification.…”

supporting

confidence: 63%

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Editors’ Note to: Comparison of adductor canal block and IPACK block (interspace between the popliteal artery and the capsule of the posterior knee) with adductor canal block alone after total knee arthroplasty: a prospective control trial on pain and knee function in immediate postoperative period

2020

Eur J Orthop Surg Traumatol

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supporting

confidence: 63%

“…The Editor-in-Chief of the European Journal of Orthopaedic Surgery and Traumatology are issuing an Editor's Note for this article [1]. It was brought to our attention that the results overlap with a previously published article by Reddy et al [2].…”

mentioning

confidence: 82%

Editors’ Note to: Comparison of adductor canal block and IPACK block (interspace between the popliteal artery and the capsule of the posterior knee) with adductor canal block alone after total knee arthroplasty: a prospective control trial on pain and knee function in immediate postoperative period

2020

Eur J Orthop Surg Traumatol

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“…1 and 2A, B), and it has been postulated to provide effective posterior knee analgesia after TKA without causing distal neurological motor deficits. [23][24][25] The purpose of this retrospective cohort study was to compare early outcomes with respect to length of stay and pain relief in patients who underwent primary TKA comparing femoral and sciatic (Fem þ Sci) combination motor nerve blocks versus the interspace between the popliteal artery and the capsule of the posterior knee and ACB (IPACK þ ACB) combination sensory nerve block.…”

mentioning

confidence: 99%

Decreased Opioid Consumption and Length of Stay Using an IPACK and Adductor Canal Nerve Block following Total Knee Arthroplasty

et al. 2019

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Peripheral nerve blocks such as a femoral + sciatic block have demonstrated significant pain relief following TKA. However, these nerve blocks have residual motor deficits which prevent immediate postoperative ambulation. The purpose of this study was to compare outcomes in patients undergoing primary TKA with femoral and sciatic (Fem + Sci) motor nerve blocks versus an adductor canal and the interspace between the popliteal artery and the capsule of the posterior knee and adductor canal block (IPACK + ACB) sensory nerve blocks. A total of 100 consecutive patients were reviewed, 50 received Fem + Sci nerve blocks and 50 received IPACK + ACB blocks preoperatively. There were no differences in the two groups with respect to surgical technique, implant type, postoperative pain, and physical therapy protocols. Differences in opioid requirements, length of stay (LOS), distance walked, and common knee scoring systems were analyzed. Among them, 62% IPACK + ACB patients were discharged on postoperative day 1 compared with 14% in the Fem + Sci group (p < 0.0001). The IPACK + ACB patients had a shorter LOS (mean 1.48 days vs. 2.02 days, p < 0.001), ambulated further on postoperative day 0 (mean 21.4 feet vs. 5.3 feet, p < 0.001), and required less narcotics the day after surgery (mean, 15.7 vs. 24.0 morphine equivalents p < 0.0001) and at 2 weeks (mean, 6.2 vs. 9.3 morphine equivalents, p = 0.025). The use of this combination IPACK and ACB demonstrated improved early ambulation with a decrease in opioid use and length of stay compared with a femoral and sciatic motor nerve block in patients undergoing primary TKA.

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“…There are few studies published in the literature evaluating the role of IPACK in pain management after total knee arthroplasty. Sankineani et al [27] reported a significantly improved range of motion and walking distance as well as reduced visual analogue scale scores on the day of surgery for a group receiving ACB and IPACK compared with a group receiving ACB alone after total knee arthroplasty. Elliot et al [28], in a study comparing patients who received ACB and IPACK after total knee Fig.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the postoperative analgesic effect for infiltration between the popliteal artery and the capsule of the posterior knee and that of periarticular multimodal drug injection in total knee arthroplasty: retrospective study in the immediate postoperative period

Jung

Shon

Seo

et al. 2020

Knee Surg & Relat Res

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Background: The aim of this study is to compare the postoperative analgesic effect of infiltration between the popliteal artery and the capsule of the knee (IPACK) and the effect of periarticular multimodal drug injection (PMDI) in addition to adductor canal block (ACB) after total knee arthroplasty. Methods: Among patients who received total knee arthroplasty from June 2017 to December 2017, 50 who underwent ACB with additional IPACK and 50 who received ACB with additional PMDI were selected for this study. We compared the postoperative pain numerical rating scale (NRS), the number of times patient-controlled analgesia was administered and the amount administered, the total amount of opioids given, and complications associated with the procedure between the two groups. Results: NRS measured at rest and 45°knee flexion at days 1 and 2 after surgery was significantly lower in the IPACK group than in the PMDI group. The resting NRS measured at day 3 after surgery was also significantly lower in the IPACK group than in the PMDI group, and the NRS at 45°knee flexion measured from day 3 to day 5 showed a significant reduction in the IPACK group. No complications relating to the procedure occurred. Conclusions: IPACK may be a better option than PMDI for controlling acute phase pain in patients undergoing total knee arthroplasty.

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Comparison of adductor canal block and IPACK block (interspace between the popliteal artery and the capsule of the posterior knee) with adductor canal block alone after total knee arthroplasty: a prospective control trial on pain and knee function in immediate postoperative period

Abstract: ACB + IPACK is a promising technique that offers improved pain management in the immediate postoperative period without affecting the motor function around the knee joint resulting in better ROM and ambulation compared to ACB alone.

Cited by 129 publications

References 19 publications

Decreased Opioid Consumption and Length of Stay Using an IPACK and Adductor Canal Nerve Block following Total Knee Arthroplasty

Comparison of the postoperative analgesic effect for infiltration between the popliteal artery and the capsule of the posterior knee and that of periarticular multimodal drug injection in total knee arthroplasty: retrospective study in the immediate postoperative period

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